A revolutionary view on endometriosis related pain

There are clues for the "neuropathic" component in endometriosis pain

Key Points

Highlights:

• Endometriosis, as a chronic inflammatory condition, has an important component of pain amongst clinical symptoms. 
• Endometriosis-related pain is regarded as nociceptive, via receptors to harmful stimuli, but clinical symptomatology also suggests its neuropathic (related to nerves) component.

Importance:

• Endometriosis-associated pain is debilitating for many women and may also have a neuropathic component that could change clinical management.

What’s done here:

• The authors have made a cross-sectional study via the utilization of an online survey.
• This survey was through the endometriosis support internet sites assessing pain and psychological measures besides questions about surgeries.

Key results:

• Endometriosis-related pain was classified as neuropathic in 40% and combined neuropathic/nociceptive in 35%. The neuropathic pain group had higher pain intensities besides greater psychological distress and cognitive impairment.
• Neuropathic pain seems to be more in patients with a higher number of endometriosis surgeries to the abdomen and also with a rather long history of pain.

Limitations:

• The data obtained were not independently verified clinical findings.
• Participants were recruited from patient support groups that might not necessarily be representative of the whole endometriosis patient population.

Lay Summary

Dr. Lydia Coxon and colleagues from Oxford University, UK, have recently published their cross-sectional study on the categorization of endometriosis-related pain in the journal "Frontiers in Pain Research".

As a chronic inflammatory condition, endometriosis results in pelvic pain, dysmenorrhea, and dyspareunia not related to disease burden. In the current research, the prevalence of neuropathic-like pain in endometriosis using a questionnaire screening hypothesizes that endometriosis-associated pain would be classified as neuropathic in some women. Similar to other patients with neuropathic pain these women could have higher depression and anxiety symptoms.

A cross-sectional study via utilization of an online survey was made through endometriosis support internet sites. The questionnaire was composed of questions assessing pain and psychological measures besides the history of previous surgeries.

The survey on endometriosis-related pain on 1,417 responses yielded an important subgroup of neuropathic pain in 40% and also combined neuropathic/nociceptive in another 35%. This neuropathic pain group had higher pain intensities along with greater psychological distress and cognitive impairment. Neuropathic pain seems to be more in patients with a higher number of abdominal surgical operations and also in those with a rather long history of pain.

This cross-sectional research has yielded that endometriosis-associated pain may have a neuropathic-like component in an important number of endometriosis patients. The findings of this current research encourage further investigations on this subject. The classical endometriosis-associated pain concept that debilitating a large number of patients may well have a new perspective yielding better clinical management outcomes.

Research Source: https://pubmed.ncbi.nlm.nih.gov/35295529/